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Background: Physical activity and BMI have been individually associated with cancer survivorship but have not yet been studied in combinations in colorectal cancer patients. Here, we investigate individual and combined associations of physical activity and BMI groups with colorectal cancer survival outcomes., Methods: Self-reported physical activity levels (MET hrs/wk) were assessed using an adapted version of the International Physical Activity Questionnaire (IPAQ) at baseline in 931 patients with stage I-III colorectal cancer and classified into 'highly active' and'not-highly active'(≥ / < 18 MET hrs/wk). BMI (kg/m 2 ) was categorized into 'normal weight', 'overweight', and 'obese'. Patients were further classified into combined physical activity and BMI groups. Cox-proportional hazard models with Firth correction were computed to assess associations [hazard ratio (HR), 95% profile HR likelihood confidence interval (95% CI) between individual and combined physical activity and BMI groups with overall and disease-free survival in colorectal cancer patients., Results: 'Not-highly active' compared to 'highly active' and 'overweight'/ 'obese' compared to 'normal weight' patients had a 40-50% increased risk of death or recurrence (HR: 1.41 (95% CI: 0.99-2.06), p = 0.03; HR: 1.49 (95% CI: 1.02-2.21) and HR: 1.51 (95% CI: 1.02-2.26), p = 0.04, respectively). 'Not-highly active' patients had worse disease-free survival outcomes, regardless of their BMI, compared to 'highly active/normal weight' patients. 'Not-highly active/obese' patients had a 3.66 times increased risk of death or recurrence compared to 'highly active/normal weight' patients (HR: 4.66 (95% CI: 1.75-9.10), p = 0.002). Lower activity thresholds yielded smaller effect sizes., Conclusion: Physical activity and BMI were individually associated with disease-free survival among colorectal cancer patients. Physical activity seems to improve survival outcomes in patients regardless of their BMI., (© 2023. The Author(s).)

Background: The aim of this study is to review accelerometer wear methods and correlations between accelerometry and physical activity questionnaire data, depending on participant characteristics., Methods: We included 57 articles about physical activity measurement by accelerometry and questionnaires. Criteria were to have at least 100 participants of at least 18 years of age with manuscripts available in English. Accelerometer wear methods were compared. Spearman and Pearson correlation coefficients between questionnaires and accelerometers and differences between genders, age categories, and body mass index (BMI) categories were assessed., Results: In most investigations, requested wear time was seven days during waking hours and devices were mostly attached on hips with waist belts. A minimum of four valid days with wear time of at least ten hours per day was required in most studies. Correlations (r = Pearson, ρ = Spearman) of total questionnaire scores against accelerometer measures across individual studies ranged from r = 0.08 to ρ = 0.58 (P < 0.001) for men and from r = -0.02 to r = 0.49 (P < 0.01) for women. Correlations for total physical activity among participants with ages ≤65 ranged from r = 0.04 to ρ = 0.47 (P < 0.001) and from r = 0.16 (P = 0.02) to r = 0.53 (P < 0.01) among the elderly (≥65 years). Few studies investigated stratification by BMI, with varying cut points and inconsistent results., Conclusion: Accelerometers appear to provide slightly more consistent results in relation to self-reported physical activity among men. Nevertheless, due to overall limited consistency, different aspects measured by each method, and differences in the dimensions studied, it is advised that studies use both questionnaires and accelerometers to gain the most complete physical activity information.

Background: Physical activity plays an important role in colorectal cancer and accelerometry is more frequently used to measure physical activity. The aim of this study was to evaluate feasibility of physical activity measurement by accelerometry in colorectal cancer patients under free-living conditions at 6, 12 and 24 months after surgery, to evaluate the appropriate wear time and to compare results to pedometry., Methods: Colorectal cancer patients (stage 0/I-IV) from the ColoCare study were asked to optionally wear an accelerometer and a pedometer for ten consecutive days 6, 12 and 24 months post-surgery. Participants completed a feedback questionnaire about the accelerometer measurement. The course of moderate-to-vigorous physical activity over the 10 days was investigated. Additionally, daily step counts from accelerometers and pedometers were compared., Results: In total, there were 317 individual time points, at which 198 participants were asked to wear an accelerometer. Fifty-nine% initially agreed to participate and of these, 83% (n = 156) completed the assessment with at least 4 days of data. Twenty-one% more consents were obtained when participants were asked on a face-to-face basis compared to recruitment by telephone (P = 0.0002). There were no significant differences in time spent in moderate-to-vigorous physical activity between different wear-time lengths of accelerometry. Both Spearman and intraclass correlation coefficients showed strong correlations (0.92-0.99 and 0.84-0.99, respectively) of moderate-to-vigorous physical activity across 3, 4, 7 and 10 days measurement. Step counts measured by accelerometry and pedometry were strongly correlated (ρ = 0.91, P < 0.0001)., Conclusion: This study suggest that accelerometry is a feasible method to assess physical activity in free-living colorectal cancer patients and that three valid days of physical activity measurement are sufficient for an accurate assessment.